Haruo Taniguchi

Diffuse submucosal cysts and carcinoma of the stomach

Gastric submucosal cysts, carcinomas, and atypical hyperplasia have been observed in the superficial mucosa of 12 stomachs. It is thought that gastritis may give rise to these heterotopic glands, that the development of heterotopic cysts in the submucosa may make the surface mucosa prone to erosion, and that repeated erosion and regeneration may cause carcinoma or atypical hyperplasia.

Endoscopic diagnosis of early gastric cancer by the endoscopic congo red‐methylene blue test

The endoscopic Congo red test combined with dyeing with methylene blue was performed in 85 patients with early gastric cancer (94 lesions). Results revealed that gastric cancer bleached the Congo red and methylene blue sprayed over their surface and this appeared in sharp contrast to the red‐colored mucosa of unaffected areas. Grossly, polypoid and flat types, and histologically differentiated adenocarcinomas bleached the dyes more frequently and more intensely than depressed and undifferentiated adenocarcinomas. Thus the spread of cancerous growth could be judged rather accurately and so the target area could be reached by biopsy in cases where there were few if any visual signs of abnormality.

A cytologic study on small cell carcinoma of the esophagus

The cytologic picture of small cell carcinoma primarily arising from the esophagus was studied with 7 cases which were confirmed by histologic examination. Cytomorphologic characteristics of small cell carcinoma of the esophagus are as follows: the arrangement of groups of tumor cells is irregular and overlapping with indistinct cell boundaries. The cytoplasm is small, or sometimes absent. The nuclei are round, oval or occasionally spindle shaped. Nuclear borders are thin. The chromatin of finely granular pattern has increased and is evenly distributed.

Chromoendoscopic Observations on Extension and Development of Fundal Gastritis and Intestinal Metaplasia

The development and extension of fundal gastritis and intestinal metaplasia were investigated by the endoscopic Congo red-methylene blue test in 44 healthy subjects, 106 patients with gastric ulcer, and 26 patients with gastric polyp. Follow-up chromoendoscopic examinations were made an average of 3.4 yr (range 1-10 yr) after the initial endoscopic assessment. Fundal gastritis and intestinal metaplasia developed or became more extensive with time in only 3 (6.8%) and 2 (4.5%) healthy subjects, respectively. In patients with gastric ulcer and in those with gastric polyp, fundal gastritis and intestinal metaplasia developed or extended significantly more frequently and more rapidly than in healthy subjects. Fundal gastritis and intestinal metaplasia developed or became more extensive, respectively, in 26 (24.5%) and 23 (21.7%) patients with gastric ulcer and in 10 (38.5%) and 10 (38.5%) patients with gastric polyp. Fundal gastritis and intestinal metaplasia extended with time mainly in an upward direction.

Diffuse leiomyomatosis of the esophagus

SummaryA case of diffuse leiomyomatosis of the esophagus which was successfully resected is presented. The patient was a 44-year-old man who had an abnormal filling defect, which was incidentally discovered during esophagography, and was observed for two years. Although he remained asymptomatic, an operation was performed because of increase in the tumors size. The lesion consisted of many confluent myomatous nodules throughout the thoracic portion of the esophagus, mostly seen in the circular layer of the muscularis, and some in the muscularis mucosa. Histologically, these nodules were leiomyomas. This is a very rare condition, and only a dozen similar cases have been reported so far. A brief discussion is made on the definition of diffuse leiomyomatosis of the esophagus.

Gastric hamartomatous polyps in the absence of familial polyposis coli

Hamartomatous polyps in the stomach have been described as gastric lesions of familial polyposis coli. Four cases of multiple gastric hamartomatous polyps not associated with polyposis coli were encountered. Histologically, all these polyps consisted of normal oxyntic glands with numerous cystic dilatations of the glandular lumens of various sizes. Endoscopically, the polyps were all located in the acid secreting area and had an acid secreting function, which was revealed by the endoscopic Congo red test. Cancer 45:818‐823, 1980.

Primary adenoid cystic carcinoma of the esophagus. Report of a case

A case of primary adenoid cystic carcinoma of the esophagus is reported. A 51‐year‐old male patient had a tumor in the lower third of the esophagus which was incidentally found during an examination for cholelithiasis, and resected successfully. The tumor exhibited a polypoid appearance covered by normal esophageal epithelium, localized entirely in the submucosal layer, and morphologically identical to adenoid cystic carcinoma in the salivary glands. The patient is still alive and well three and one‐half years after surgery. This seems to be a typical case of adenoid cystic carcinoma of the esophagus arising from the submucosal esophageal gland.

Gross and histological types of early gastric carcinomas in relation to the acid‐secreting area

The relation of gastric acid‐secreting function to the gross and histological types and locations of carcinomas was examined in 53 patients with early gastric carcinomas. Studies were made by the endoscopic Congo red test developed in this clinic. Results indicated a close correlation between the gross and histological types of early gastric carcinoma and the extent of the acid‐secreting area. In general, when the acid‐secreting area was large, the carcinomas were ulcerated and histologically undifferentiated, and they were chiefly located in nonacid‐secreting areas adjacent to acid‐secreting areas, or sometimes they were surrounded by acid‐secreting areas. On the contrary, when there was little or no acid‐secreting area the carcinomas were polypoid and histologically differentiated, and they were located in nonacid‐secreting areas far from acid‐secreting areas.

Effects of gastrin and histamine on gastric carcinogenesis induced in rats by N-methyl-N′-nitro-N-nitrosoguanidine

Abstract The effects of gastrin and histamine on the incidence and histology of gastric cancer induced by N -methyl- N′ -nitro- N -nitrosoguanidine were investigated in Wistar strain rats. It was found that prolonged administration of gastrin or histamine after treatment with N -methyl- N′ -nitro- N -nitrosoguanidine resulted in a significant reduction in the incidence of adenocarcinomas of the glandular stomach. Histological examination showed that unlike the highly differentiated adenocarcinomas with a typical glandular structure in the control group and the histamine-treated group, the adenocarcinomas that did develop in rats after prolonged administration of gastrin had little or no typical glandular structure. These results showed that both gastrin and histamine were related to reduction in the incidence of adenocarcinomas in the glandular stomach, whereas the histological type of adenocarcinoma was affected only by gastrin.

Polyps in the acid-secreting area of the stomach

The relation of gastric polyps to acid-secreting mucosa was examined in 120 patients with gastric polyps. Studies were made by the endoscopic Congo red test developed in this clinic. In 23 patients (19.1%) gastric polyps were located in acid-secreting mucosa and may have arisen from normal oxyntic mucosa. These polyps were of two histological types: oxyntic gland polyps containing many parietal cells, and nonoxyntic gland polyps without parietal cells. Only the former type appeared to secrete acid, judging endoscopically from the change of Congo red from red to blue-black on the surface of the polyps after administration of gastrin.